title: Rapid sequential endothelial keratoplasty with and without combined cataract extraction.
abstract: OBJECTIVE
  To evaluate the outcomes of bilateral Descemet membrane endothelial keratoplasty (DMEK) combined with cataract extraction as indicated within a 1- to 2-week timeframe for treatment of Fuchs endothelial corneal dystrophy.
  
  
  METHODS
  Private practice, Indianapolis, Indiana, USA.
  
  
  METHODS
  Case series.
  
  
  METHODS
  This retrospective review identified patients who had DMEK in both eyes within 2 weeks.
  
  
  RESULTS
  The study comprised 12 patients (median age 61 years). Seven patients had bilateral DMEK 1 week apart and 5 patients, 2 weeks apart. Twelve eyes had triple procedures (cataract extraction, intraocular lens implantation, DMEK), 7 eyes were pseudophakic before DMEK, and 5 eyes had clear lenses and remained phakic after DMEK. Preoperatively, the median corrected distance visual acuity (CDVA) was 20/40 (range 20/15 to 20/70). By 1 month postoperatively, the median CDVA had improved to 20/25 (range 20/15 to 20/70). The median CDVA in the 10 patients examined between 3 months and 6 months postoperatively was 20/20 (range 20/15 to 20/30). All grafts successfully attached and cleared. Four patients had bilateral air reinjection and 1 patient had unilateral air reinjection to treat partial graft detachment. The rate of air reinjection was comparable between single and triple procedures (P=.65). No other complications were noted.
  
  
  CONCLUSIONS
  Patients with bilateral visual impairment associated with Fuchs dystrophy can have both eyes treated with DMEK within 1 to 2 weeks. With DMEK, corneal transplantation begins to approach cataract surgery in the speed of visual recovery and the time to full resumption of daily activities.
authors.affiliation: Price Vision Group and the Cornea Research Foundation of America, Indianapolis, Indiana, USA.
authors.forename: Yuri
authors.initials: Y
authors.lastname: McKee
authors.forename: Marianne O
authors.initials: MO
authors.lastname: Price
authors.forename: Lauren
authors.initials: L
authors.lastname: Gunderson
authors.forename: Francis W
authors.initials: FW
authors.lastname: Price
mesh_terms: D000328:Adult; D000368:Aged; D002386:Cataract / Q000150:complications; D002452:Cell Count; D063171:Corneal Pachymetry; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000150:complications / Q000601:surgery*; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology